0001209191-14-048732.txt : 20140723 0001209191-14-048732.hdr.sgml : 20140723 20140723202058 ACCESSION NUMBER: 0001209191-14-048732 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140722 FILED AS OF DATE: 20140723 DATE AS OF CHANGE: 20140723 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLASE, INC CENTRAL INDEX KEY: 0000811240 STANDARD INDUSTRIAL CLASSIFICATION: DENTAL EQUIPMENT & SUPPLIES [3843] IRS NUMBER: 870442441 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: BIOLASE TECHNOLOGY INC DATE OF NAME CHANGE: 19941117 FORMER COMPANY: FORMER CONFORMED NAME: LASER MEDICAL TECHNOLOGY INC DATE OF NAME CHANGE: 19941117 FORMER COMPANY: FORMER CONFORMED NAME: LASER ENDO TECHNIC CORP DATE OF NAME CHANGE: 19920708 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLARK PAUL N CENTRAL INDEX KEY: 0001222248 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 14989787 MAIL ADDRESS: STREET 1: 5301 STEVENS CREEK BLVD STREET 2: MS 1A-LC CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-07-22 0 0000811240 BIOLASE, INC BIOL 0001222248 CLARK PAUL N 4 CROMWELL IRVINE CA 92603 1 0 0 0 Common Stock, par value $0.001 per share 2014-07-22 4 P 0 520833 1.92 A 605954 I By Trust /s/ Michael C. Carroll, attorney-in-fact for Paul N. Clark 2014-07-23